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Yusuke Ome, Kazuki Hashida, Mitsuru Yokota, Yoshio Nagahisa, Okabe Michio, Kazuyuki Kawamoto
BACKGROUND: Laparoscopic distal pancreatectomy (Lap-DP) for benign lesions or those with low malignant potential has been proven safe and effective, and its performance is now widespread [1-3]. Lap-DP for left-sided pancreatic cancer (PC) is also being increasingly performed. According to some reports, Lap-DP has superior short-term outcomes (blood loss, postoperative hospital stay) and comparable oncological outcomes and overall survival with those of open distal pancreatectomy (Op-DP) [4-6]...
April 13, 2017: Surgical Endoscopy
Tsetsegdemberel Bat-Ulzii Davidson, Mohammad Yaghoobi, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: The treatment of people with clinically significant postoperative pancreatic leaks is different from those without clinically significant pancreatic leaks. It is important to know the diagnostic accuracy of drain fluid amylase as a triage test for the detection of clinically significant pancreatic leaks, so that an informed decision can be made as to whether the patient with a suspected pancreatic leak needs further investigations and treatment. There is currently no systematic review of the diagnostic test accuracy of drain fluid amylase for the diagnosis of clinically relevant pancreatic leak...
April 7, 2017: Cochrane Database of Systematic Reviews
Masaru Kanehira, Yasuro Futagawa, Kenei Furukawa, Hiroaki Shiba, Tadashi Uwagawa, Katsuhiko Yanaga
BACKGROUND: Therapeutic outcomes and prognosis of primary unresectable duodenal cancer remains unsatisfactory, because effective chemotherapy is not established. CASE PRESENTATION: A 71-year-old male diagnosed with unresectable duodenal carcinoma with distant lymph node metastases was judged inoperable (cT3N2M1 cStage in UICC(7th)). Duodenal obstruction developed due to tumor growth, and the patient underwent laparoscopic gastro-jejunostomy and then combined chemotherapy using S-1 and cisplatin...
December 2017: Surgical Case Reports
Shuichi Aoki, Hiroaki Miyata, Mitsukazu Gotoh, Fuyuhiko Motoi, Hiraku Kumamaru, Hiroyuki Konno, Go Wakabayashi, Yoshihiro Kakeji, Masaki Mori, Yasuyuki Seto, Michiaki Unno
BACKGROUND: The morbidity rate after pancreaticoduodenectomy remains high. The objectives of this retrospective cohort study were to clarify the risk factors associated with serious morbidity (Clavien-Dindo classification grades IV-V), and create complication risk calculators using the Japanese National Clinical Database. METHODS: Between 2011 and 2012, data from 17564 patients who underwent pancreaticoduodenectomy at 1311 institutions in Japan were recorded in this database...
February 14, 2017: Journal of Hepato-biliary-pancreatic Sciences
Fritz Klein, Igor Maximilian Sauer, Johann Pratschke, Marcus Bahra
Introduction. Postoperative pancreatic fistula formation remains the major complication after distal pancreatectomy. At our institution, we have recently developed a novel bovine serum albumin-glutaraldehyde sealed hand sutured fish-mouth closure technique of the pancreatic remnant during distal pancreatectomy. The aim of this study was to analyze the impact of this approach with regard to technical feasibility and overall postoperative outcome. Patients and Methods. 32 patients who underwent a bovine serum albumin-glutaraldehyde sealed hand sutured fish-mouth closure of the pancreatic remnant during distal pancreatectomy between 2012 and 2014 at our institution were analyzed for clinically relevant postoperative pancreatic fistula formation (Grades B and C according to ISGPF definition) and overall postoperative morbidity...
2017: HPB Surgery: a World Journal of Hepatic, Pancreatic and Biliary Surgery
Fiorella Pendola, Rahul Gadde, Caroline Ripat, Rishika Sharma, Omar Picado, Laila Lobo, Danny Sleeman, Alan S Livingstone, Nipun Merchant, Danny Yakoub
BACKGROUND: The value of spleen preservation with distal pancreatectomy (DP) for benign and low grade malignant tumors remains unclear. The aim of this study was to evaluate the short-term postoperative clinical outcomes in patients undergoing DP with splenectomy (DPS) or spleen preservation (SPDP). METHODS: Online database search was performed (2000 to present); key bibliographies were reviewed. Studies comparing patients undergoing DP with either DPS or SPDP, and assessing postoperative complications were included...
February 2017: Journal of Surgical Oncology
Thijs de Rooij, Federica Cipriani, Majd Rawashdeh, Susan van Dieren, Salvatore Barbaro, Mahmoud Abuawwad, Jony van Hilst, Martina Fontana, Marc G Besselink, Mohammed Abu Hilal
BACKGROUND: Laparoscopic distal pancreatectomy (LDP) is becoming the standard treatment for left-sided pancreatic disease. Learning curve identification is essential to ensure a safe and steady expansion. However, large (n > 30) single-surgeon learning curve series are lacking. STUDY DESIGN: Data of all patients undergoing LDP between June 2007 and March 2016 by a single surgeon were collected prospectively. For learning curve analysis, the first 10, 20, 30, 40, and 50 LDPs were compared with LDPs performed thereafter...
January 24, 2017: Journal of the American College of Surgeons
C M Kühlbrey, N Samiei, O Sick, F Makowiec, U T Hopt, U A Wittel
BACKGROUND: Morbidity after pancreas resection is still high with postoperative pancreatic fistulas (POPF) being the most frequent complication. However, exocrine insufficiency seems to protect from POPF. In clinical practice, patients showing increased postoperative systemic amylase concentrations appear to frequently develop POPF. We therefore retrospectively examined the occurrence of systemic amylase increase after pancreas resections and its association with the clinical course. PATIENTS AND METHODS: Perioperative data from 739 consecutive pancreas resections were assessed in a prospectively maintained SPSS database...
November 28, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Masanori Sugiyama, Yutaka Suzuki, Tetsuya Nakazato, Masaaki Yokoyama, Masaharu Kogure, Nobutsugu Abe
BACKGROUND: Duct-to-mucosa pancreatojejunostomy after pancreatoduodenectomy can be technically difficult, particularly in cases with a non-dilated pancreatic duct. We devised a novel procedure employing a pancreatic duct holder and mucosa squeeze-out technique facilitating duct-to-mucosa anastomosis. We compared the perioperative outcomes of pancreatoduodenectomy with duct-to-mucosa pancreatojejunostomy between the novel and conventional procedures. METHODS: Our pancreatic holder has a cone-shaped tip with a slit...
August 8, 2016: World Journal of Surgery
Matthew T McMillan, Giuseppe Malleo, Claudio Bassi, Valentina Allegrini, Luca Casetti, Jeffrey A Drebin, Alessandro Esposito, Luca Landoni, Major K Lee, Alessandra Pulvirenti, Robert E Roses, Roberto Salvia, Charles M Vollmer
OBJECTIVE: This multicenter study sought to prospectively evaluate a drain management protocol for pancreatoduodenectomy (PD). BACKGROUND: Recent evidence suggests value for both selective drain placement and early drain removal for PD. Both strategies have been associated with reduced rates of clinically relevant pancreatic fistula (CR-POPF)-the most common and morbid complication after PD. METHODS: The protocol was applied to 260 consecutive PDs performed at two institutions over 17 months...
June 24, 2016: Annals of Surgery
A Papalampros, K Niehaus, D Moris, M Fard-Aghaie, G Stavrou, A-G Margonis, A Angelou, K Oldhafer
INTRODUCTION: Postoperative pancreatic fistula (POPF) is one of the most frequent and serious postoperative complications of pancreatoduodenectomy (PD). We sought to assess the impact of a novel pancreaticojejunostomy (PJ) on the rates of POPF and overall postoperative complications. METHODS: Between 01/2010 and 12/2013, a total of 248 consecutive patients who underwent PD with a modified PJ were identified from our database and retrospectively analyzed. POPF cases were divided into three categories (ISGPF-international study group-guidelines): biochemical fistula without clinical sequelae (grade A), fistula requiring any therapeutic intervention (grade B), and fistula with severe clinical sequelae (grade C)...
December 2016: Journal of Visceral Surgery
A Giardino, G Spolverato, P Regi, I Frigerio, F Scopelliti, R Girelli, Z Pawlik, P Pederzoli, C Bassi, G Butturini
BACKGROUND: The association between postoperative inflammatory markers and risk of complications after pancreaticoduodenectomy (PD) is controversial. We sought to assess the diagnostic value of perioperative C-reactive protein (CRP) and procalcitonin (PCT) levels in the early identification of patients at risk for complications after PD. METHODS: In 2014, 84 patients undergoing elective PD were enrolled in a prospective database. Clinicopathological characteristics, CRP and PCT, as well as short-term outcomes, such as complications and pancreatic fistula, were analyzed...
August 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Marta Sandini, Giuseppe Malleo, Luca Gianotti
BACKGROUND/AIM: Different scoring systems to predict the occurrence of postoperative pancreatic fistula (POPF) after pancreatoduodenectomy have been described, but the considered risk factors often suffer subjective scaling. The aim of this review is to evaluate and compare all published risk metrics predictive of POPF. METHODS: All existing scores were retrieved by literature web search. Inclusion criteria were ISGPF classification of POPF and the development of a risk score metric...
2016: Digestive Surgery
Wooil Kwon, Jin-Young Jang, Jung Hoon Kim, Ye Rim Chang, Woohyun Jung, Mee Joo Kang, Sun-Whe Kim
BACKGROUND: Whether splenectomy is adverse or spleen preservation offers significant advantages in distal pancreatic resection is unclear. The aim was to compare the early/late clinical results and the functional outcomes in terms of quality of life (QoL) and nutrition between conventional laparoscopic distal pancreatectomy (LDP) and laparoscopic spleen-preserving distal pancreatectomy (LSPDP). STUDY DESIGN: Clinical data and computed tomography findings of 111 laparoscopic distal resections (79 LDPs and 32 LSPDPs) between 1999 and 2012 were retrospectively reviewed...
May 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Chi-Hua Fang, Qing-Shan Chen, Jian Yang, Fei Xiang, Zhao-Shan Fang, Wen Zhu
BACKGROUND: A majority of factors associated with the occurrence of clinical relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD) can only be identified intra- or postoperatively. There are no reports for assessing the morphological features of pancreatic stump and analyzing its influence on CR-POPF risk after PD preoperatively. METHOD: A total of 90 patients underwent PD between April 2012 and May 2014 in our hospital were included...
June 2016: World Journal of Surgery
A G Kriger, S V Berelavichus, D S Gorin, A R Kaldarov, N A Karel'skaya, E A Akhtanin
AIM: To compare the results of robot-assisted and conventional techniques of pancreatoduodenectomy. MATERIAL AND METHODS: It was performed the retrospective investigation of results of robot-assisted and conventional pylorus-preserving pancreatoduodenectomy in 7 and 7 patients respectively. RESULTS: Duration of robot-assisted and conventional surgery was 460.71±119.77 and 288.57±62.2 minutes, volume of blood loss--414.28±285.36 and 400±163...
2015: Khirurgiia
Hanbaro Kim, Ki Byung Song, Dae Wook Hwang, Jae Hoon Lee, Sang Hyun Shin, Eun Sung Jun, Seong-Ryong Kim, Bong Jun Kwak, Tae Gu Kim, Kwang-Min Park, Young-Joo Lee, Song Cheol Kim
BACKGROUND: Preservation of the spleen in distal pancreatectomy has recently attracted considerable attention. Our current study aimed in the first instance to define the safety of lap-WT in relation to the capacity of this technique to achieve preservation of the spleen and secondly to investigate the effectiveness of a planned lap-WT procedure or early conversion to lap-WT in selected patients with a large tumor attached to the splenic vessels. METHODS: Among 1056 patients who underwent a laparoscopic distal pancreatectomy between January 2005 and December 2014 at our hospital, 122 (24...
September 2016: Surgical Endoscopy
M Abu Hilal, J R C Richardson, T de Rooij, E Dimovska, H Al-Saati, M G Besselink
BACKGROUND: Laparoscopic left pancreatectomy has been well described for benign pancreatic lesions, but its role in pancreatic adenocarcinoma remains open to debate. We report our results adopting a laparoscopic technique that obeys established oncologic principles of open distal pancreatosplenectomy. METHODS: This is a post hoc analysis of a prospectively kept database of 135 consecutive patients undergoing laparoscopic left pancreatectomy, performed across two sites in the UK and the Netherlands (07/2007-07/2015 Southampton and 10/2013-07/2015 Amsterdam)...
September 2016: Surgical Endoscopy
Abigail E Vallance, Alastair L Young, Christian Macutkiewicz, Keith J Roberts, Andrew M Smith
BACKGROUND: A post-operative pancreatic fistula (POPF) is a major cause of morbidity and mortality after a pancreaticoduodenectomy (PD). This systematic review aimed to identify all scoring systems to predict POPF after a PD, consider their clinical applicability and assess the study quality. METHOD: An electronic search was performed of Medline (1946-2014) and EMBASE (1996-2014) databases. Results were screened according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and quality assessed according to the QUIPS (quality in prognostic studies) tool...
November 2015: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Sung-Jin Park, Hyung-Il Seo, Soo-Hee Go, Sung-Pil Yun, Ji-Yeon Lee
BACKGROUNDS/AIMS: The objective of this study was to evaluate the relationship between initial personal experiences with distal pancreatectomy and perioperative risk factors, outcomes, and management of pancreatic fistulas. METHODS: Between May, 2007 and May, 2010, a total of 28 patients who had undergone elective distal pancreatectomy were evaluated for this study. Perioperative factors and the occurrence of pancreatic fistula were analyzed on the basis of International Study Group of Pancreatic Fistula (ISGPF) criteria...
November 2011: Korean Journal of Hepato-biliary-pancreatic Surgery
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